Persistent Diuresis Associated Dapagliflozin Treatment

Abstract

odium glucose cotransporter 2 (SGLT2) inhibitors are oral antidiabetic drugs that improve urinary excretion of glucose, in this way regulating glycemic control and promoting weight loss. 1 The mechanism of action of SGLT2 inhibitors is a blood sugar reduction independent of insulin. 2 Diabetic ketoacidosis (DKA) is most serious acute metabolic complication of diabetes. 3 The use of oral antidiabetic agents including SLGT-2 inhibitors in the treatment of diabetic ketoacidosis is rare. 4,5 In the literature, the case of euglycemic diabetic ketoacidosis associated with canagliflozine has been discussed. In this case; persistent diuresis is discussed after normoglisemia. 6 However, an article about dapagliflozin is not available in the literature. In this article we will present diabetic ketoacidosis developed during the use of dapagliflozin. Persistent diurezis was discussed after acidosis was treatment and normoglycemia was maintained. CASE REPORT 55 years old male patient who had diabetes mellitus and HbA1c 15 mg/dL was recommended intensive insulin therapy by his internal medician doctor. The patient refused to use this treatment. Another doctor prescribed vildagliptin-metformin and dapagliflozin treatment to the patient. The patient used only dapagliflozin from this treatment regimen. The patient was brought back by his relatives due to nausea and vomiting after 4 months of starting oral antidiabetic treatment. The patient had nausea, vomiting and abdominal pain. On the day of admission to the hospital, the change of consciousness developed. He did smoke but didn't use alcohol.